Provider Demographics
NPI:1891892469
Name:CENTER FOR COUNSELING AND BEHAVIORAL MEDICINE
Entity Type:Organization
Organization Name:CENTER FOR COUNSELING AND BEHAVIORAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:B
Authorized Official - Last Name:MEKHOUBAT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:804-717-5419
Mailing Address - Street 1:PO BOX 2215
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-9112
Mailing Address - Country:US
Mailing Address - Phone:804-717-5419
Mailing Address - Fax:804-520-8595
Practice Address - Street 1:10106 KRAUSE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-6572
Practice Address - Country:US
Practice Address - Phone:804-717-5419
Practice Address - Fax:804-520-8595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA087856OtherSENTARA
VA178550OtherCOMPSYCH
VA7346205OtherAETNA HEALTH CARE
VA2007414OtherCIGNA BEHAVIORAL HEALTH
VA323687OtherANTHEM BCBS
VA366110OtherVALUE OPTIONS
VA342367OtherMAMSI
VA237206OtherANTHEM HEALTHKEEPERS
VA=========OtherTRICARE